Dr Yu-Ray Chen, Professor of Surgery at Chang Gung Memorial Hospital discusses the current state of Taiwan’s healthcare system, highlighting the fact that its current condition is unsustainable in the long run, and emphasizes the importance of international growth and collaboration for CGMH over the next five years. 

Chang Gung Memorial Hospital (CGMH) was founded nearly 40 decades ago. Could you provide us a brief insight into the history and evolution of the hospital?

The hospital was founded in 1976, at a time when Taiwan’s economy was booming. Despite a surging economy, the quality of Taiwan’s medical services, trailed significantly behind the global standard. In addition, the medical system on offer was exclusive and expensive in nature.

With the intention of providing the Taiwanese public a high quality, affordable, inclusive healthcare system, Formosa Plastic Group Chairman Yung-Ching Wang and President Yung-Tsai Wang established Chang Gung Memorial Hospital (CGMH).

Moreover, in the 1970s, there were a limited number of institutions offering training to domestic medical graduates, and there was a lack of demand for medical professionals who had studied abroad and desired to work back home. CGMH laid out Taiwan’s medical educational blueprint, recognizing both the importance of cutting edge research and the cultivation of local talent. Today CGMH is Taiwan’s medical academic hub, providing a comprehensive educational and training platform for a range of medical students and attracting talent from around the world.

Since our founding the hospital has gradually augmented its facilities, number of patients and quality of services. CGMH has also established itself as a center of excellence in teaching and pharmaceutical research. Today, Chang Gung is one of Taiwan’s largest medical centers, with a service network that includes its headquarters, five branches across the island and more than 21,000 employees including nearly 3,500 medical doctors. To evolve from a basic level to a world-class teaching hospital in a relatively short period of time has been a remarkable and proud achievement.

Is Taiwan’s highly acclaimed universal health care system sustainable?

The healthcare system in Taiwan is at a juncture. As a result of political gaming, and a complex government position, the system has transformed from a medical insurance service to a welfare service.

Taiwan’s healthcare system is hemorrhaging capital, an issue that has become economically unsustainable for a number of smaller healthcare facilities. Yet, the government has been reluctant to address this problem, either by tightening the healthcare expense belt or raising the insurance contribution of the people, because such a move is deemed as political suicide.

The population needs educating on this issue to understand that quality services need to be financed. There is no such thing as a free lunch. Furthermore, the system should not be exploited. In Taiwan, despite a golden era of public healthiness, inpatient and outpatient appointments are growing annually. It is the politician’s responsibility to educate the people and help them to understand that healthcare resources are finite and should be used appropriately.

In practical terms, there is a need to rebalance and streamline this unmaintainable system. However, in reality, because of the political capital at stake, the government is likely to continue down the same path. Inclusive healthcare is more than an expected service; it is a symbol of Taiwan.

In 2012 CGMH formed a clinical trials partnership with GSK. What is CGMH’s competitive edge over other hospitals offering clinical trial services?

CGMH is right in the heart of Taiwan’s drug development ecosystem. Indeed, at our new clinical R&D center, we are currently conducting over 20 clinical trials covering medical treatments. International and local companies are drawn to partnering with us because of a variety of factors.

Firstly and perhaps most crucially in the arena of clinical trials, we have a strong track record. For instance, our medical laboratories have international accreditation, specifically from CAP (College of American Pathologists). Likewise our chemical and animal labs have international accreditation. Such validation in an area fraught with risk instills confidence and trust in our data. Thirdly, because of our sheer size and abundant facilities, we can assess the effectiveness of pharmaceutical drugs with efficacy.

CGMH’s Executive Administrator Sue Heui Cheng has stated Taiwan’s high quality medical care deserves international publicity. How can CGMH achieve that aim?

Taiwan’s current medical standard is on par with the global hierarchy, and we produce such quality at a relatively low cost. We have generated an array of pioneering medical techniques in the fields of head and neck reconstruction, joint replacement, liver transplantation and cord blood transplantation as well as neurosurgery.

Furthermore, CGMH has achieved a number of breakthroughs in patient care and we have initiated a number of prominent contributions in both clinical and basic science research from our various departments. Harnessing international publicity and projecting ourselves on a global stage is now at the core of CGMH’s objectives.

What impact has ECFA had on the hospital’s operations?

The undercurrent of the agreement for Taiwan is that the mainland may entice a lot of our medical human resources because of the attractive remuneration packages across the strait. Yet, overall, ECFA should have a positive impact on our medical services.

As discussed, Taiwan’s healthcare service is synonymous with quality and high standards and naturally many patients in the Chinese market are drawn to such an environment. Although the potential for this market is thwarted by visa complications (Chinese patients cannot stay in Taiwan for a long period of time), the situation is improving and being addressed by the parties bilaterally.

What will be the impact of the YC Wang Advanced Medicine and Innovation Park on the growth of the hospital’s widespread capabilities?

It is an exciting time for us as we open the delivery of the park with proton center in 2014. The range of facilities under construction are cutting edge and will bolster our ambitions of being globally recognized. The park will enhance our research and treatment capability of a number of diseases, particularly cancers, like hepatoma.

What would you have liked the hospital to have achieved in five years’ time?

Over the last few years we have invested a considerable amount of capital towards enhancing and adding operational muscle to our research system and the results are starting to bear fruit. Following an already sprouting growth trend, we expect the number of research projects over the next few years to grow exponentially.

Recently, as a result of our maturing research expertise, we achieved a breakthrough development with the sale of a patent to a French company. The patent is derived from an indigo naturalis ointment that treats the skin disease psoriasis. Such giant research strides can hopefully catalyze the development of other successful products.

The Chang Gung family has remained firmly attached to its enduring philosophy: “Serving the interests of patients first”, in tandem with providing a world class service. The resource capability, track record and expanding patient footfall puts Chang Gung in a strong position to assess what products are beneficial to the patient. We are angling CGMH towards an international path and invite partners around the world to collaborate with us.